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 Military Fillable Immunization Record Form 2012

Dha 116 2012-2025 Form

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What is the Military Fillable Immunization Record Form

The Military Fillable Immunization Record Form, often referred to as the dha form 116, is an essential document used by military personnel and their families to track immunizations. This form serves as a comprehensive record of vaccinations received, ensuring that service members meet health requirements for deployment and other military obligations. It is particularly important for maintaining readiness and compliance with military health standards.

How to use the Military Fillable Immunization Record Form

Using the dha form 116 involves several steps to ensure that all necessary information is accurately recorded. First, gather all relevant immunization records and personal information, including your name, service number, and date of birth. Next, fill in the specific vaccines received, including dates and administering healthcare providers. Once completed, this form can be submitted to the appropriate military health office or kept for personal records. Utilizing digital tools can streamline this process, making it easier to fill out and store securely.

Steps to complete the Military Fillable Immunization Record Form

Completing the dha form 116 requires careful attention to detail. Follow these steps:

  • Download the latest version of the dha form 116 from a reliable source.
  • Fill in your personal information, including full name, service number, and date of birth.
  • List each immunization received, including the vaccine name, date administered, and the name of the healthcare provider.
  • Review the form for accuracy and completeness.
  • Sign and date the form to validate the information provided.

Legal use of the Military Fillable Immunization Record Form

The dha form 116 is legally recognized as an official record of immunizations within the military context. Compliance with military health regulations is essential for service members, as failure to maintain accurate immunization records can lead to penalties or restrictions on deployment. The form must be filled out accurately and submitted to the appropriate military health authorities to ensure legal validity.

Key elements of the Military Fillable Immunization Record Form

Several key elements must be included on the dha form 116 to ensure it serves its purpose effectively. These elements include:

  • Personal Information: Full name, service number, and date of birth.
  • Immunization History: A detailed list of vaccines received, including dates and healthcare providers.
  • Signature: The signature of the individual completing the form, verifying the accuracy of the information.

Form Submission Methods

The completed dha form 116 can be submitted through various methods, depending on the requirements of the military health office. Common submission methods include:

  • Online Submission: Many military health facilities allow for digital submission through secure portals.
  • Mail: The form can be printed and mailed to the appropriate health office.
  • In-Person: Service members may also choose to deliver the form in person during a visit to their healthcare provider.

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